OASIS-E Spotlight: Repetition of Three Words

July 10, 2023

Making sense of CMS guidelines is more challenging than ever after the launch of OASIS-E and the abundance of changes that go along with it. KanTime’s OASIS Spotlight series will spotlight specific OASIS items to simplify the ruling and help clinicians significantly improve their understanding of OASIS so they can move forward with accuracy.


This week we’ll continue to look at the items that make up the BIMS. Once it is determined that the BIMS is an appropriate tool for your patient, their ability to repeat 3 specific words is evaluated.

According to the OASIS-E Guidance Manual:

“The inability to repeat three words on first attempt may indicate:

    • a memory impairment
    • a hearing impairment,
    • a language barrier, or
    • inattention that may be a sign of delirium or another health issue.”

Time points:

Start of Care
Resumption of Care
Discharge from agency

Repetition of Three Words
Ask patient: “I am going to say three words for you to remember. Please repeat the words after I have said all three. The words are: sock, blue and bed. Now tell me the three words.”

Number of words repeated after first attempt

Code 0, None, if the patient did not repeat any of the 3 words on the first attempt.
Code 1, One, if the patient repeated only 1 of the 3 words on the first attempt.
Code 2, Two, if the patient repeated only 2 of the 3 words on the first attempt.
Code 3, Three, if the patient repeated all 3 words on the first attempt.

Dash is a valid response for this item.
A dash indicates “no information.” CMS expects dash use to be a rare occurrence.

Additional OASIS Guidance includes:

    • The words may be repeated in any order.
    • If the patient correctly stated all three words, say, “That’s right, the words are sock, something to wear; blue, a color; and bed, a piece of furniture” [category cues].
    • If the patient recalled two or fewer words, say to the patient: “Let me say the three words again. They are sock, something to wear; blue, a color; and bed, a piece of furniture. Now tell me the three words.”
    • If the patient still does not recall all three words correctly, you may repeat the words and category cues one more time.
    • Putting words in context stimulates learning and fosters memory of the words that patients will be asked to recall in item C0400, even among patients able to repeat the words immediately.
    • Do not score the number of repeated words on a second or third attempt.

Stay tuned for next Monday’s spotlight so your practice can continue to stay ahead of the curve and provide elite patient care through the Oasis E changes.

We provide clinicians that are part of the Kantime enterprise system with links to the guidance from CMS for each individual OASIS item.

If you would like to learn more about how better happens, contact us at sales@kanrad.com to schedule a demo.

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